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Trouble in Mind

An Unorthodox Introduction to Psychiatry

Dean F. MacKinnon, M.D.

Publication Year: 2011

Orthodox psychiatric texts are often rich in facts, but thin in concept. Depression may be defined as a dysfunction of mood, but of what use is a mood? How can anxiety be both symptom and adaptation to stress? What links the disparate disabilities of perception and reasoning in schizophrenia? Why does the same situation push one person into drink, drugs, danger, or despair and bounce harmlessly off another? Trouble in Mind is unorthodox because it models adaptive mental function along with mental illness to answer questions like these. From experience as a Johns Hopkins clinician, educator, and researcher, Dean F. MacKinnon offers a unique perspective on the nature of human anguish, unreason, disability, and self-destruction. He shows what mental illness can teach about the mind, from molecules to memory to motivation to meaning. MacKinnon’s fascinating model of the mind as a vital function will enlighten anyone intrigued by the mysteries of thought, feeling, and behavior. Clinicians in training will especially appreciate the way mental illness can illuminate normal mental processes, as medical illness in general teaches about normal body functions. For students, the book also includes useful guides to psychiatric assessment and diagnosis.

Published by: The Johns Hopkins University Press

Title Page, Copyright, Dedication

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pp. vii-viii

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pp. ix-xv

Pundits periodically pitch spitballs at my profession. Psychiatry, they say, rates somewhere between hocus pocus and a threat to Western civilization. Mental illness is a social construct, psychotherapy is a scam, pharmaceuticals only dull the pain, involuntary hospitalization and electroconvulsive therapy —barbaric! ...


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pp. xvii

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1. Organic Mind

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pp. 1-28

Many people confuse psychology and psychiatry. The two have surprisingly little to do with each other. Psychology refers to the study of the mind, a field of inquiry encompassing a set of theories that inform research and clinical work. Psychiatry refers to a field of medicine. ...

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2. Elementary Mind

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pp. 29-71

The mind has two main sources of input: sensation, stimulated by the environment, and arousal, stimulated by signals from the body. The mind has one main conduit for output: orchestrated skeletal muscle contraction. ...

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3. Integral Mind

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pp. 72-119

The primary elements of mental life—pure perception, programs that direct action, raw arousal, undirected appetite—barely register in the subjective world, but the results of their integration are more familiar: thoughts, intentions, and feelings. ...

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4. Synthetic Mind

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pp. 120-172

Now the story advances from the elemental and integrative mental processes found in many animal species to the uniquely human processes that permit us to weigh options when motives clash and to act intelligently in uncertain circumstances. ...

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5. Psychiatric Mind

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pp. 173-199

We have come to the end of our trek through the mind and mental dysfunction, from norepinephrine to neurons to neuroses. We now can map troublesome mental symptoms, propensities, experiences, and behaviors to specific adaptive functions. ...

Appendix A: The Official Version: A Guided Tour of the DSM

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pp. 201-225

Appendix B: The Novice’s Guide to Psychiatric Assessment

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pp. 227-271


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pp. 273-287


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pp. 289-309

Additional Reading

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pp. 311-312

Index [Includes About the Author and About the Cover]

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pp. 313-323

E-ISBN-13: 9780801899607
E-ISBN-10: 0801899605
Print-ISBN-13: 9780801898075
Print-ISBN-10: 0801898072

Page Count: 352
Illustrations: 6 b&w illus.
Publication Year: 2011